lecture 19: CN XI and XII

Question 1

which of the following nuclei is not shared by Cn IX and X

inferior salivatory nucleus
sensory trigeminal nucleis
nucleus ambiguous
nucleus solitaries

Answer 1

inferior salivatory nucleus

Question 2

a patient presents with a uvular deviation to the left when saying ahh and an absent gag reflex unilaterally, which of these structures is damaged

left vagus n
right vagus n
left glosso n
right glosso n

Answer 2

right vagus n

Question 3

what is CN XI

Answer 3

accessory n

Question 4

is the accessory n motor, sensory or mixed

Answer 4

motor

Question 5

what is the main function of the accessory n

Answer 5

voluntary motor innervation of sternocleidomastoid and trapezius

Question 6

what does the sternocleidomastoid muscles do

Answer 6

contralateral rotation and ipsilateral flexion of the neck

Question 7

true or false: the SCM does ipsilateral rotation and ipsilateral flexion of the neck

Answer 7

false, contralateral rotation

Question 8

what does the trapezius muscle m do

Answer 8

scapular movement, upper limb support and posterior stability

Question 9

how does the accessory n enter the skull

Answer 9

via foramen magnum

Question 10

why does the accessory n need to enter the skull thru foramen magnum

Answer 10

because it starts in cervical region of the spine

Question 11

how does the accessory n exit the skul

Answer 11

via jugular foramen

Question 12

the accessory n exits skull via via jugular foramen with what other two nerves

Answer 12

glosso and vagus

Question 13

where is the accessory nuclei located

Answer 13

in the lateral portion of the anterior grey horn (spinal root from c1-c5/6

Question 14

true or false: the accessory nuclei is located in the lateral portion of anterior grey horn

Answer 14

true

Question 15

spinal root for accessory nuclei is what cervical levels

Answer 15

c1-c5./c6

Question 16

true or false, accessory nuclei get corticonuclear input

Answer 16

true

Question 17

is the accessory nuclei somatic or branchial motor

Answer 17

branchial motor

Question 18

is there a cranial component to the accessory nuclei

Answer 18

yes it is associated with nucleus ambigguus
(cranial root believed to join the vagus nerve en route to muscles of palate, larynx and pharynx

Question 19

explain the UMN control of the XI n

Answer 19

1) UMN in primary motor cortex (neck area)
2) corona radiata
3) internal capsule (gene)
4) cerebral peduncle
5) basal pons
6) pyramids (decussation)
=ipsialteral for SCM
=contralateral for trap

7) synapse with LMN in accessory motor nucleis

Question 20

explain what happens at the pyramids for cortciconuclear control of the CN XI

Answer 20

UMN stays ipsialtearl for the SCM
UMN goes contralateral for trapezius

Question 21

where do UMN synapse with LMN for the CN XI

Answer 21

in accessory nuclei

Question 22

is hypoglossal n purely motor, sensory or mixed

Answer 22

motor

Question 23

what is the general function of the hypoglossal n

Answer 23

voluntary motor innervation of intrinsic tongue muscles (change the shape of the tongue)

voluntary motor innervation of all extrinsic tongue muscles (except palatoglossus CN X)
=movement of the tongue

Question 24

what do the intrinsic muscles of the tongue do to the tongue

Answer 24

change the shape of the tongue

Question 25

what do the extrinsic muscles of the tongue do

Answer 25

movement of the tongue (retraction. elevation)

Question 26

what are some examples of external tongue muscles

Answer 26

genioglossus hyoglossus styloglossus (palatoglossues)

Question 27

what is the only extrinsic tongue muscle not innevated by the hypoglossal

Answer 27

palatoglossus (CN X)

Question 28

which n innervates palatoglossus

Answer 28

CN X

Question 29

how does the hypoglossal n exit the skull

Answer 29

via the hypoglossal canal (at the edge of the foramen magnum)

Question 30

the hypoglossal nucleus is what type of nucleus

Answer 30

somatic motor

Question 31

true or false; the hypoglossal nucleus carries motor innervation to all muscles of the tongue

Answer 31

false, all muscles except palatoglossus

Question 32

where does the hypoglossal nerve emerge from in the brainstem

Answer 32

emerges from the medulla ventral to the olives (between pyramids and olives)

Question 33

true or false, the hypoglossal n emerges from the medulla dorsal to the olives with CN IX and X

Answer 33

false, ventral

Question 34

what is the level of the brainstem where we would find hypoglossal nucelus

Answer 34

rostral medulla

Question 35

what is the characteretisc symptom for a trapezius problem

Answer 35

shoulder droop

Question 36

what is the characteretisc symptom for a SCM problem

Answer 36

weak SCM (Difficulty turning to opposite side)

Question 37

will the symptoms for a trapezius issue always be contralateral to the lesion

Answer 37

no contralat for UMN ipsilat for LMN

Question 38

will the symptoms for a SCM issue always be contralateral to the lesion

Answer 38

false, always IPSI

Question 39

an UMN of spinal accessory will cause what deficits

Answer 39

deficits to the contralateral trapezius deficits to the ipsilat SCM (difficulty turning to opposite side)

Question 40

person lesions the UMN of the spinal accessory at the right cerebral peduncle, what is the symptoms

Answer 40

deficits to the left trapezius (left shoulder drop) deficits to the right SCM (difficulty turning to left side)

Question 41

an LMN of spinal accessory will cause what deficits

Answer 41

deficits to the ipsilateral trapezius deficits to the ipsilat SCM (difficulty turning to opposite side)

Question 42

person lesions the LMN of the left spinal accessory nucleus, what are the symptoms

Answer 42

deficits to the left trapezius (left shoulder drop) deficits to the Left SCM (difficulty turning to right side)

Question 43

a person has an issue with their right trapezius and right SCM at the same time, is the lesion UMN or LMN

Answer 43

LMN

Question 44

true or false: the hypoglossal and spinal accessory nucleus are both. branchial motoro

Answer 44

false accessory=branchial hypoglossal=somatic

Question 45

explain pathway for UMN (corticinucleuar) for hypoglossal n

Answer 45

1) UMN in primary motor cortex (tongue region) 2) corona radiate 3) IC (genu) 4) cerebral peduncle 5) basal pons 6) synapse with LMN in the hypoglossal nucleus -contraltaeral for the genioglossus only -bilateral for all other tongue muscles

Question 46

explain the synapse with LMN in the hypoglossal corticunuclear pathway (ie> explain the decussation)

Answer 46

-contraltaeral for the genioglossus only -bilateral for all other tongue muscles

Question 47

what is the function of the genioglossues muscle

Answer 47

tongue protrude

Question 48

true or false and why: the majority of the tongue muscles will be unaffected by an UMN lesion

Answer 48

true because they receive bilateral innervation

Question 49

explain the deficits seen in an UMN nerve palsy for hypoglossal n

Answer 49

UMN lesion results in tongue deviation to the contralateral side (paralyzing contralateral genioglossus)

Question 50

an UMN lesion results in tongue deviation to the BLANK side (paralyzing Blank genioglossus)

Answer 50

contrlatearl for both

Question 51

an UMN lesion results in tongue deviation to the contralateral side (paralyzing BLANK genioglossus)

Answer 51

CONTRLATERAL

Question 52

If i lesion my right UMN in hypoglossal n pathway, what will be the deficits

Answer 52

tongue will deviate towards contralateral side/left side (paralyze my left genioglossues)

Question 53

If i lesion my right LMN in hypoglossal n pathway, what will be the deficits

Answer 53

tongue will deviate towards ipsilateral side/right side (paralyze my right genioglossues) rightside of tongue will looks fucked up (fasciualtions)

Question 54

explain the deficits seen in a LMN nerve palsy for hypoglossal n

Answer 54

LMN lesion results in tongue deviation to the ipsilateral side (paralyzing ipsialteral genioglossus) tongue will not be symmetrical (ie facsiculatinons, weird appearance on one side since all muscles affected)

Question 55

a LMN lesion results in tongue deviation to the BLANK side (paralyzing Blank genioglossus)

Answer 55

ipsualtearl for both

Question 56

a LMN lesion results in tongue deviation to the ipsialteal side (paralyzing BLANK genioglossus)

Answer 56

ipsialteral

Question 57

add slides on medial medullary syndrome

Question 58

what is the associated foramen of the accessory n

Answer 58

enter skull thru foramen magnum exit through jug foramen

Question 59

true or false, the spinal accessory innervates the SCM and the lat dorsi

Answer 59

false, the SCM and trap